Oral cancer natural history, complications and prognosis: Difference between revisions

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** 90% -  If cancer is found early and  before it has spread to other tissues.
** 90% -  If cancer is found early and  before it has spread to other tissues.
** More than half of oral cancers have spread when the cancer is detected. Most have spread to the [[throat]] or neck.<ref>{{Cite web | title = National Library of Medicine prognosis of oral cancer| url =https://www.nlm.nih.gov/medlineplus/ency/article/001035.htm }}</ref> With early detection and timely treatment, deaths from oral cancer could be dramatically reduced. The 5-year survival rate for those with localized disease at diagnosis is 83 percent compared with only 32 percent for those whose cancer has spread to other parts of the body.
** More than half of oral cancers have spread when the cancer is detected. Most have spread to the [[throat]] or neck.<ref>{{Cite web | title = National Library of Medicine prognosis of oral cancer| url =https://www.nlm.nih.gov/medlineplus/ency/article/001035.htm }}</ref> With early detection and timely treatment, deaths from oral cancer could be dramatically reduced. The 5-year survival rate for those with localized disease at diagnosis is 83 percent compared with only 32 percent for those whose cancer has spread to other parts of the body.
The following are prognostic factors for squamous cell carcinoma. Grading is not a very useful prognostic factor as it does not indicate treatment response or survival.<ref>{{Cite web | title = Canadian cancer society prognosis of oral cancer| url =http://www.cancer.ca/en/cancer-information/cancer-type/oral/prognosis-and-survival/?region=ab }}</ref>


===Stage===
== Complications ==
*Direct surgical complications include [[infection]], [[bleeding]], [[aspiration]], wound breakdown, flap loss, and [[fistula]].


The size of the tumor and extent to which the cancer has spread to the [[lymph nodes]] are the main prognostic factors. Larger and more extensive late-stage tumors have a poor prognosis.
*Complications of [[chemotherapy]] includes the following:<ref name="pmid9591859">{{cite journal| author=Pauloski BR, Rademaker AW, Logemann JA, Colangelo LA| title=Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients. | journal=Otolaryngol Head Neck Surg | year= 1998 | volume= 118 | issue= 5 | pages= 616-24 | pmid=9591859 | doi=10.1177/019459989811800509 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9591859  }}</ref>
 
**[[Neurotoxicity]]- This complication is a side effect of certain classes of drugs, such as the [[Vinca alkaloids|vinca alkaloids.]]
===Site===
**[[Bleeding]]
 
*Complications of [[radiation therapy]] includes the following:<ref name="pmid18707827">{{cite journal| author=Gomez DR, Zhung JE, Gomez J, Chan K, Wu AJ, Wolden SL et al.| title=Intensity-modulated radiotherapy in postoperative treatment of oral cavity cancers. | journal=Int J Radiat Oncol Biol Phys | year= 2009 | volume= 73 | issue= 4 | pages= 1096-103 | pmid=18707827 | doi=10.1016/j.ijrobp.2008.05.024 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18707827  }}</ref>
The prognosis also depends on whether the primary tumor is on the lips, tongue, gums or the lining of the mouth.
**[[Radiation]] [[caries]]
 
**[[Trismus]]
===Resection margin===
**[[Osteonecrosis]]
 
*Complications common to both [[chemotherapy]] and [[radiation]] include the following:<ref name="pmid19531406">{{cite journal| author=Oh HK, Chambers MS, Martin JW, Lim HJ, Park HJ| title=Osteoradionecrosis of the mandible: treatment outcomes and factors influencing the progress of osteoradionecrosis. | journal=J Oral Maxillofac Surg | year= 2009 | volume= 67 | issue= 7 | pages= 1378-86 | pmid=19531406 | doi=10.1016/j.joms.2009.02.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19531406  }}</ref>
If the cancer extends to the outer margin of the tissue removed during surgery, it is called a positive resection margin. A negative resection margin indicates a good prognosis.
**Oral [[mucositis]]
 
**Chronic [[dysphagia]]
===Tumor thickness===
**[[Anemia]]
 
**Pharyngocutaneous [[fistula]]
The thicker the tumor, the poorer the prognosis.
**[[Aspiration]]
 
**[[Infections]] such as [[viral]], [[bacterial]], and [[fungal]] that results from [[myelosuppression]], [[xerostomia]], and damage to the mucosa from [[radiotherapy]] or [[chemotherapy]]
===Vascular invasion===
**[[Xerostomia]]
 
**Functional disabilities such as impaired ability to swallow, eat, taste and speak because of [[trismus]], [[dry mouth]], [[mucositis]], and i[[Infection|nfection]]
The prognosis is poor if the cancer has spread to the [[blood vessels]], which may result in rapid and widespread [[metastases]].
**Nutritional compromise such as poor nutrition from eating difficulties caused by  dry mouth, [[mucositis]], [[dysphagia]], and [[loss of taste]].
**Abnormal [[dental]] development
***Altered tooth development, [[craniofacial]] growth, or skeletal development in children secondary to high doses of [[chemotherapy]] and [[Radiation therapy|radiotherapy]] before age 9.


==References==
==References==

Revision as of 16:00, 5 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. The 5-year survival rate for oral cancer diagnosed early is 75% compared to 20% for oral cancer diagnosed late.

Prognosis

  • The prognosis (chance of recovery) depends on the following:
  • 5-year survival rate for oral cancer:
    • Diagnosed early is 75%
    • Diagnosed late is 20%
  • Cure rate :
    • 90% - If cancer is found early and before it has spread to other tissues.
    • More than half of oral cancers have spread when the cancer is detected. Most have spread to the throat or neck.[1] With early detection and timely treatment, deaths from oral cancer could be dramatically reduced. The 5-year survival rate for those with localized disease at diagnosis is 83 percent compared with only 32 percent for those whose cancer has spread to other parts of the body.

Complications

References

  1. "National Library of Medicine prognosis of oral cancer".
  2. Pauloski BR, Rademaker AW, Logemann JA, Colangelo LA (1998). "Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients". Otolaryngol Head Neck Surg. 118 (5): 616–24. doi:10.1177/019459989811800509. PMID 9591859.
  3. Gomez DR, Zhung JE, Gomez J, Chan K, Wu AJ, Wolden SL; et al. (2009). "Intensity-modulated radiotherapy in postoperative treatment of oral cavity cancers". Int J Radiat Oncol Biol Phys. 73 (4): 1096–103. doi:10.1016/j.ijrobp.2008.05.024. PMID 18707827.
  4. Oh HK, Chambers MS, Martin JW, Lim HJ, Park HJ (2009). "Osteoradionecrosis of the mandible: treatment outcomes and factors influencing the progress of osteoradionecrosis". J Oral Maxillofac Surg. 67 (7): 1378–86. doi:10.1016/j.joms.2009.02.008. PMID 19531406.


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